Explorer back on trek
N APRIL last year, James MorrisManuel was enjoying a welldeserved skiing holiday abroad when tragedy struck. He was involved in an accident that rendered him injured and immobile on the slopes, requiring him to be taken by sledge to the nearest medical institution for urgent treatment. Bedridden, in pain, and with little information about the nature, severity or likely outcome of his injury, James was keen to get home as soon as possible. He was flown back to England after five days in a brace and an ambulance transported him straight back to his home.
His GP referred him to me, a consultant spinal surgeon at Highgate Hospital. Due to James’ immobility, I paid him a home visit to examine him and assess his injury, with the aid of the x-rays and scans from abroad. Scans showed that he had fractured one of his lumbar vertebrae and he had been told that he might be paralysed if he moved inadvertently and that he was likely to need surgery to stablise the fracture.
The MRI scan showed a darkened area within one vertebra. This injury can, in some cases, cause eventual collapse of the vertebra, which explained the concern of his doctors abroad.
Getting the right advice early on is so important, as it can reduce discomfort and anxiety and shorten the recovery time.
And for James, there was another factor. He was committed to an expedition in 2016 to raise funds for Norwood’s activities supporting children and adults with learning disabilities. He was supposed to be travelling to the Arctic Circle for a trek, leading his own pack of huskies, building an igloo and surviving the tough terrain, snow-capped mountains, frozen lakes and forests. James did not want to let Norwood down.
I went through all the options and advised James strongly against surgery, despite the information he had previously been given. I felt that a programme of specialist spinal physiotherapy, along with a thermoplastic brace to provide individual contoured support, would be preferable.
Having a specialist mobile bed to allow him to rest between his exercises, as well as the unfailing support of his family, were also major factors in his recovery.
I followed up James every few weeks with repeated imaging to check on the state of the fracture and the team at Highgate Private Hospital were delighted to oversee his steady improvement.
As the months passed, the imaging confirmed the healing of the broken vertebra. He has been able to discard his brace for the occasional use of an elasticated corset support and he has improved in strength, mobility and endurance, so that now, nearly nine months on from the injury, he is almost back to full strength.
Next week, he is setting off on his fundraising expedition, fully able to participate. I wish him every success on his forthcoming expedition.
The moral of the story? Spinal fractures can be very frightening and finding the right path isn’t always straightforward. Not all fractures require surgery — what is important is that you see a specialist, have the right tests done and get the right advice to ensure you have a speedy recovery.